Doctors of Running

What do you get when a DPT and DVM walk into a bar? Clinical Analysis of Running, Running Footwear, and Injury Prevention/Performance.
We are the Doctors Who Run, combining our knowledge of the biomechanics of bipeds and your furry friends.

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Saturday, March 10, 2018

I know, you are probably thinking, "great, another VaporFly 4% review....we know it is the miracle shoe (Editor's Note: Spoiler Alert, it isn't - Dr. Klein). You went out for your normal run, but miraculously ran 2 min/mile faster and you have never done that before!" Also let me guess, your feet felt fresh and ready to tackle any length of run? Well, that is what you will read and hear anecdotally from people. I for one am a little skeptical about a company making such grandiose claims. Granted there is a lot of research behind this shoe, and evidence supporting that this shoe makes you run more efficient, faster, etc etc. Matt and I try to do our best to provide a thorough evaluation of every running shoe that we review with a bio-mechanical/scientific perspective. So here is my review (with Matt's input) of the super hyped running shoe, the VaporFly 4%.

Excellent shaped toe box for a racing flat. Note the very minimal upper and non-existent heel counter. You can't argue the looks of these shoes.

Upper and Fit
The first thing that jumps out at you is the design of the shoe. Nike does a very consistent job of making shoes that look fast and ones that are fashionably acceptable for casual wear (well, if you are into that sort of thing). The upper in general is minimal in deign and materials. It is a one piece upper made up of an engineered mesh, an almost non-existent heel counter, and a more traditional lacing system (hooray no fly wire!). The toe box is rather generous and the overall volume of the shoe is rather high, which came as a surprise for a shoe that is marketed as a racing flat. This higher volume isn't necessarily a bad thing, but does allow a wider range of feet to work with this shoe. For individuals like myself with narrow feet, you will have to really cinch down the laces. The unfortunate side effect is a bunching of the upper (see pictures below) and pressure on the top of the foot proximal (closer to the ankle). The heel hold is minimal, with a thin piece of material acting as a "heel counter-" if you have any extra mobility in the posterior foot you are forewarned. Overall, the foot is held in place, but I imagine that normal width to higher volume feet having fewer to no issues with the lacing. There really isn't any structure to this upper, just a paper thin engineered mesh holding the foot to the massive miracle ZoomX midsole. I still would recommend going true to size, because going down a half size will place your toes rather close to the front of the shoe. The tongue is not my favorite, as it is very thin and acts as a pressure point on top of the foot. Overall, the upper isn't anything special and I would argue that the Nike Streak 6 has a much more comfortable upper and hold.

Despite a very minimal upper, the foot is held rather secure. You can some what appreciate how much I cranked the laces to make it snug though. This higher volume is not the best for a narrow foot. The leads to bunching of the upper and pressure on the top of the foot. You can also appreciate the aggressive pointed heel flare.

Midsole
This is the part you have been waiting for in this review, "what do Matt and I think about this new midsole and carbon fiber plate?" That's because the midsole with its ZoomX foam and full length embedded carbon fiber plate is what all the hype is about. To be honest, I'm not a fan. This shoe has some major flaws that I see as a potential issue for many runners (including elites). Let's first discuss the last or shape of the shoe. The heel has an exaggerated point with a marked curvature going straight back like a rudder on a boat. This heel flare paired with an extremely narrow midfoot, curved shape, very high stack height, and extreme toe spring makes for one unstable shoe. It would be like comparing a jeep to a corvette, where you have excellent cushioning but your center of gravity is way too high. Just standing in the shoe I can appreciate my midfoot sagging over the medial aspect of the shoe (and I have a very narrow foot). This sensation is amplified when running on anything other then a completely flat straight surface. The whole foot collapses inwards and results in the upper digging into the top of my foot. Unless you have perfect biomechanics (but honestly, what is the epitome of perfect biomechanics?), I don't see how this shoe could be comfortable in the long run. My concerns are compounded with the pain and overall discomfort in my forefoot. Speaking of the forefoot, this brings me to point number two of the midsole. The shoe has absolutely no flexibility. The VaporFly is a giant block of foam and is reminiscent of the earliest models from Hokka One One. Yes, the midsole is responsive along with the embedded carbon plate. But the problem is the forefoot is not allowed to flex normally at the metatarsals heads and locks your foot in a static position throughout the gait cycle. These forefoot issues are compounded with the aggressive toe spring, which locks your foot in dorsiflexion (i.e. more pressure is placed on the metatarsals during the gait cycle). Finally, the aggressive heel flare paired with a lack of any structure to the heel results in excessive motion in the posterior foot....an injury waiting to happen in those with extra mobility there. I'll let Matt Klein address all of these stability aspects in the Biomechanics section of this review.

One can see the strategically placed rubber on the forefoot and heel area to help with durability. Also, appreciate the narrowness of the midfoot. Granted, most racing flats have a narrow midfoot. But pair this narrowness with a really high stack height and it can lead to some problems.

Ride
The ZoomX is soft underfoot with a nice bounce. It reminds me of Hokka's RMAT midsole material or if the Adidas Adizero Boston was two times softer. All of this soft responsive foam is controlled with an embedded full length carbon plate. This plate does add a sense of propulsion, but as mentioned before, causes a lot of irritation once you've run for several miles. The ZoomX foam is responsive, but I don't feel it is anything revolutionary. I feel that honor goes to Adidas' Boost, despite other companies jumping on the bandwagon - Saucony's EVERUN, Brooks DNA AMP, Reebok's FloatRide, and now Nike's ZoomX and React foam.

Thoughts as a DPT: While I am impressed with the marketing campaign behind the Vaporfly 4% (that's basically what the sub 2 hour attempt from Nike was. A marketing ploy. Still an awesome thing to broadcast. Definitely enjoyed it), there are many biomechanical issues that I have. Like Dr. Kollias mentioned previously, there is little to no flexibility allowed in the forefoot for the metatarsals. This is a big problem, because extension of the MTP joints (metatarsophalangeal joints) is an essential component of the terminal stance or PROPULSION phase of gait. Loss of this is classic with individuals with hallux rigidis, as it is most commonly seen in the first toe (hallux). The inability to properly progress over the forefoot can cause hyperextension of the knees, calf issues, hip flexor tightness/compensation (early hip flexion to compensate for the inability to get into full hip extension). Nike has attempted to compensate for this with a great deal of toe spring, but that only goes so far. This is anecdotal, but I have had several running patients of mine present to me with a variety of lower extremity issues after running in these shoes. Cessation of running in these cleared up a great deal of their problems, but a few were able to compensate with extensive work on their ankle mobility into dorsiflexion. Ankle dorsiflexion and MTP extension are both very important for forward progression during the propulsive and end stage stance phases of gait. Take away one (MTP extension) and you need to make sure you have enough of the other. So we have been able to compensate somewhat for this, but it would be FAR better if there was some kind of flex groove at the MTP joints to allow for normal biomechanical movement at the forefoot. Limiting this is a great way to cause issues at the MTPs or higher up the chain. This is NOT to say that everyone will have problems. Only that some people might. To address the second point Dr. Kollias raised, the rearfoot does have quite a bit of posterior heel flare. While there is an extensive heel bevel, it is centered, which is not where most people land IF they land at the rearfoot (posterior lateral landings are more normal). While it is biomechanically appropriate, aerodynamically having the bevel centered like that does make sense to decrease drag. Although I do not have any data so show that there is enough wind force that decreasing drag is necessary (I did not do the biomechanical tests for Nike on this shoe, so I do not know). So those with extensive rearfoot landings may feel a bit unstable or jarring landings in this shoe, which can be rectified by trying to land a little more anterior (but this does require changing your form. DO NOT make major form changes. These should occur very gradually and carefully to avoid shocking the body with anything too new. Like any new exercise, it should be incorporated slowly).

Durability
I would expect a normal amount of miles (400-500 miles is normal for me) in a shoe with this much midsole foam and the carbon fiber plate. I have been reading online that people are getting normal wear and not less than 100 miles that was initially reported. The strategically placed outsole rubber will help with wear in the traditional quicker wearing spots (lateral heel and forefoot). The ZoomX foam is new, so time will tell how durable it really is.

Very nice looking shoe. Some of that toe spring can be appreciated here. The white foam with the creases is the ZoomX foam and that is how it normally appears. Also this is the true shape of this shoe as it has zero flexibility. Then again, this should make it rather durable with that nearly indestructible carbon fiber plate embedded in the ZoomX foam.

Rooms for Improvement
I think that Nike should get rid of the ridiculous heel flare and shorten the carbon plate so that it stops behind the metatarsal heads. I also think that lowering the overall stack height of the midsole will aid in increasing flexibility and making it an overall better long distance racing flat. Also, $250 dollars for a shoe? Really? (I know I fell for the hype, and here we are with this review. Then again, I am a shoe Geek.)

Conclusion
This review was probably much different then most other reviews published online. I feel that it is an interesting shoe, but there are many aspects that could be adjusted to make a more balanced shoe. The bizarre appearance adds an inherent instability to the shoe, which makes it a potential hazard for your biomechanics or will require an adjustment period. I think that for some people it will work amazing, while others will share my experience. But do not worry, there are plenty of other long distance racing flats available that in my opinion are superior in design and function. I know that people will argue that so many elites are winning with this shoe. Well yes that is a true point, but I would like to point out that the fastest marathon time was run in the Adidas Adios 2, and that the elites that have won in these shoes have faster times or equivalent times in other racing flats. That is all I have for this shoe. Thank you again for reading and send us your thoughts on the VaporFly 4%.

Thanks for reading!

Editor's Note: As always, the views presented on this website belong to Dr. Klein, Dr. Kollias or the selected few who contribute to these posts. This website should not and does not serve as a replacement for seeking medical care. If you are currently injured or concerned about an injury, please see your local running physical therapist. If you are in the Los Angeles area, Dr. Klein is currently taking clients for running evaluations.

***Disclaimer: These shoes were a personal purchase. We put at least 50-75 miles on trainers and 25 miles on racing flats prior to reviewing them. Currently Dr. Kollias has 30 miles on his pair in a variety of conditions. If you are a footwear rep looking for footwear reviews or consultations on development, we are currently looking to partner with companies to assist, discuss and promote footwear models. Partnership will not affect the honesty of our reviews.

Sunday, March 4, 2018

The original Chaser from 361 was an interesting shoe (REVIEW). Upon try on, I felt that it was far too heavy for a short distance racer and that it MIGHT work as a long distance racer. Then I used it for a 5k and was able to drop a 15:40 while not in good shape. I was impressed but still felt the shoe was too bulky. And finally along came the Chaser 2. This is the racer I have been waiting for from 361. Finally they have a lighter weight racing shoe that to actually differentiate itself from the KgM2 2 (REVIEW) . How does it do that? Let's talk.

Specs (per 361)
Classification: Racer
Weight: 6.8 oz
Drop: 8mm drop

Sole/Ride

The first thing I noticed about version two is how much leaner it looks. Although Running Warehouse lists the weight as similar to the previous version (8.1oz), the Chaser 2 feels and looks much lighter (as listed at 6.8oz). While I think this is also due to the fit and structure of the upper (more on this later), the weight change definitely affects the ride. Previously I stated the original felt like it would do better as a long distance racer as it feel more like a lightweight trainer with a plate. That is, until you tried to pick the pace and and the carbon fiber plate began to shine. Now with the lighter weight and feel, the Chaser 2 feels like a much faster racing shoe. The carbon fiber plate in the midsole can definitely be felt when the speed picks up. The sole is somewhat firm but a bit forgiving thanks to the QU!KFOAM. By this I mean when jogging lightly in the shoe between repetitions, it actually feels protective and doesn't beat my legs up like most overly firm racing flats. As soon as the pace picks up though, the colors change to an aggressive racer. So now this is a shoe I would use for both a 5k and marathon with confidence. This is interesting as many 361 shoes feel firmer, but this combination of the QU!KFOAM and the carbon fiber plate make the midsole feel bouncier. This may have to do with the lighter weight.

Like all 361 shoes, the outsole rubber is very durable and grippy. I first tested this shoe after some rare rain in Los Angeles and had no slipping or feelings of instability picking up the pace or going around corners. Although I have not put enough miles on this shoe to comment fully on durability (that will come more from Dr. Kollias and his extended review later), I expect this shoe to last for many miles as either a racer or a very lightweight trainer for the minimally inclined runner.

Like the previous version, the midfoot is a bit narrow. In the previous version this led to a bit of instability. The solution for this appears to be that the last of the shoe is now narrower overall. The previous version had a wider forefoot last that made for a stable push off, but the contrast led to a more unstable midfoot. The current version has a more consistent width throughout. I would have thought that would decrease stability of the shoe having what feels like a narrower forefoot last, but it felt more stable to me.

There is an 8mm drop, which is pretty consistent for most 361 shoes (8-9mm drop). Due to the plate, the heel did not feel as obtrusive as other shoes due to the fact that landing back there resulted in a decent activation of the carbon fiber plate, which still pushes you forward.

Fit/Upper

A large change from the previous version is a much more snug and lean upper. Gone is the wider fit and in its place a snugger more racing style fit. The Chaser 2 does fit narrower overall compared to the original. The upper has a little give to it, but not a ton. For this reason, those with normal to narrower width feet will feel much more at home in this shoe. It is a racing flat, which do tend to run narrower.

Fit wise the Chaser 2 fits somewhat true to size if a bit small. The upper in the forefoot was a bit narrow for me not because of the taper but because of the narrower fit overall. Which is likely what accounts more for my comment on a slightly smaller fit more than an actual length difference. So I would suggest staying with your normal size unless you have a wider foot or are between sizes. The upper has a bit of give but not much.

That being said, the snugger fit and less give from the upper greatly improves the hold of the foot on the platform. Due to the wider fit of the previous version, I did not feel the most secure at high speed. The Chaser 2 feels much more locked on without any specific hot spots that are common from other companies using things like midfoot wraps in the upper.

Finally, there is a mild heel counter in this shoe but I did not notice it extensively while running. I as always am a bit biased about the shape of the heel aspect of the upper. I generally want a split Achilles notch to give some room for the tendon during gait. However, it seems less companies are using that and I have not had any rubbing issues with the design of Chaser 2 back there. I would suggest wearing socks with this upper as it does not have the softest internal feel, but I have not had any rubbing or chaffing issues.

Thoughts as a DPT

Prior to the Nike Vaporfly, I believed that plates in the midsole should reach the full length of the foot to act as a springboard and imitate the plantar fascia. This issue with this (and the issue many of patients who train/race in that shoe have) is that a plate that limits the mobility of the MTP joints (metatarsophalangeal joints. aka your proximal toe joints) will cause issues further up the chain no matter how much toe spring you put in the shoe. The MTP joint extension is VERY important for forward propulsion during the terminal stance (push-off) stance of gait. The Chaser 2 does a much better job of this by having a carbon fiber plate in the midfoot that goes up close but does not pass the toes. This is FAR more similar to the plantarfascia (which for the most part stops at the toes to act as a force transfer mechanism), which really helps transfer forces and passively stabilize the midfoot. The carbon fiber plate is VERY responsive (as I mentioned earlier) yet stiff enough to provide some structure at speed. So while the midfoot is narrower than I would like, there is still structure to keep you going for long miles.

Conclusion:

The design, looks, fit and weight of this shoe have drastically improved over the first version. The Chaser 2 is lighter, leaner and faster, which differentiates it from the uptempo and protective 361 KgM2 2. I would still use this as a long distance racer, however it has the versatility to be used down to the 5K. For those looking for a versatile, snug fitting and eye catching racer, take a look at the 361 Chaser 2.

Thanks for reading!

Editor's Note: As always, the views presented on this website belong to myself or the selected few who contribute to these posts. This website should not and does not serve as a replacement for seeking medical care. If you are currently injured or concerned about an injury, please see your local running physical therapist. If you are in the Los Angeles area, I am currently taking clients for running evaluations.

***Disclaimer: These shoes were provided free of charge in exchange for a review by 361 USA. We very much appreciate them sending these to us and thank them for their support. This did not change the honesty of this review. We put at least 50-75 miles on trainers and 25 miles on racing flats prior to reviewing them. Currently I have 10 miles on my pair and will be sending them to Dr. Kollias for a full review (coming soon). My views are based on my extensive history in the footwear industry and years testing and developing footwear. If you are a footwear rep looking for footwear reviews or consultations on development, we are currently looking to partner with companies to assist, discuss and promote footwear models. Partnership will not affect the honesty of our reviews.

Friday, March 2, 2018

I know, I know, the Brooks Asteria has been out for a couple
of years….but it hasn’t changed yet and it is a shoe that has many features
that many people will like.It was
almost a year ago when my colleague Matt gave a short review of this shoe (only
one or two runs in the shoe).Here I
will dive in with a full review and give you all the nitty gritty details about
this uptempo/racer from Brooks Running.

Specs (per Brooks
running):

Weight - 8.3oz (Size 9 in men’s)

Drop - 8mm

Classification - Stability Racer

Fit/upper:

So Brooks has really started to step up their game in the
looks department.Gone are the days of
80’s looking shoes/shoes that you see your dad or uncle wearing at the family
BBQ on memorial weekend.Instead Brooks
has given this shoe a modern look with a sleek design, vibrant colors, and the
most comfortable upper you will ever have against your foot. I really am digging the Red colorway (I just wish
I could get the orange in the Men’s). Seriously, the upper is amazing…but how
Nathaniel?!Well, for one, the upper
has 3D [printed overlays giving a seamless feel on the top of the foot. The
upper even has a full length Cushsole S-257® (found in some of Brook’s softer
running shoes) and this only adds to the luxurious feel of the shoe, which is
further enhanced with a sock liner made of BioMoGo® foam sock liner. There is
also a generous amount of space for your toes, not cavernous though as the foot
is held firmly by the narrow running forefoot and heel.This is how a shoe should fit in my opinion,
very snug in the heel and midfoot and space for your toes to expand and move
around.Speaking of the heel, the heel
hold is phenomenal (one of the best I have experienced thus far in a running
shoe).There is a heel counter, which is
fairly stiff (people with sensitivity in the Achilles and heel be
forewarned).This set up works
wonderfully for an individual like me, who has extra mobility of the rear half
of the foot. Honestly, Brooks didn’t skimp out on comfort!This is quite the opposite one expects from a
racing flat.I have one aspect of the
upper that I dislike, but I’ll get to that at the end of this review.Oh, and this shoe fits true to size.

A very sleek modern looking shoe. I love this colorway, but the yellow and black isn't bad either. One can also see the utilization of full length BioMoGo DNA midsole and nice flew grooves in the forefoot.

Midsole/Ride:

If you have read my review of the Hyperion, then this shoe
will have some very similar midsole feel and technology (Hyperion Review Here).Just like the Hyperion, the
Asteria has a full length BioMoGo DNA midsole, which is a combination of Brook’s
BioMoGo and DNA Cushioning technology.I really enjoy this midsole material, as it feels softer at comfortable
paces and really responds when you pick up the pace.This shoe can be viewed as the stability
version of the Hyperion, but in a way it is its own shoe.The Asteria has a better designed
outsole, which is full contact and has an overall wider platform (i.e. more
stable) to push off from.Furthermore, the
transition is much smoother then the Hyperion and I feel this is due to the
transition zone in the midfoot, correctly places flex grooves in the forefoot
only, and with the use of Guide Rails in the rear foot.I know Matt touched on these in his Preview
of this shoe (HERE), but I will go in a little bit more detail and let
him throw in his two cents.The Guide
Rails work in a more organic means to guide the foot through the gait cycle.The heel is set up with higher durometer
(firmer) midsole material along the medial side along the perimeter of the shoe
and is horse shoe shaped, with a small amount of this denser foam on the
lateral side (see picture below).This
configuration helps guide the heel into a path of least resistant and is what
gives this shoe such a smooth feel through the gait cycle.Therefore, even if you are a completely
neutral runner, I think one would appreciate the extra stability….especially in
a long distance race (which is what this shoe is intended for). The last point I want to address is the propulsion
pods, which like the Hyperion, give a very nice trampoline like effect at toe
off.Overall this shoe has a firm ride,
which works synergistically with the other stability elements I have already
mentioned and contributes to its fast feel.

Thoughts as a DPT (Dr. Klein): As I mentioned in my initial review, the Brooks Asteria is one of the few running shoes out there that has both medial and lateral rearfoot posting. Most companies only post the medial aspect of the foot, which only accounts for those who overpronate (and this doesn't always affect or help those who do over pronate or have uncontrolled subtalar eversion). I must first be clear that pronation of the foot is very normal and important for normal shock absorption. Overpronation is a bit of an arbitrary term and I prefer the term excessive mobility, because that leaves thing a bit more open to focus on specific joints and how them may affect global motions. Dr. Kollias has a bit of extra mobility in his calcaneus, which can set him up for a bit of an unstable landing as a light heel/midfoot striker. He is VERY light on his feet (which is why he gets so many miles out of his shoes), however that instability can get to him a bit of trouble. This shows up for him as knee pain as his quadriceps attempts to stabilize his knee on the somewhat unstable base he is landing on. This is further confounded by some gluteal issues, which he is working on and having a great deal of success with in terms of strength, stability and speed. The mobility and position of the heel bone can dictate a great deal of what happens farther down into the forefoot. Instability there can by compensated for elsewhere, which usually means wasted energy that could be used for propulsion. In Dr. Kollias's cases, the rearfoot stability provided by the posting, or "guide rails" serves to guide him nicely forward without influencing anything in his forefoot (which is stiff... and you don't want additional posting where someone is stiff). This is what stability should do. Guide you, not force you in a direction. The Asteria, although I love it, does not work for me because my calcaneus is stiff and my extra mobility occurs at my forefoot. Which is why forefoot stabilized shoes like the Skechers Forza 3 (REVIEW) work very well. So as always, you need to find the shoe that works for you. Some people may need some additional stability back at the heel. Others who do not even make contact there will love it for the very neutral forefoot ride.

One can appreciate the firmer midsole material on the medial aspect of the heel. This is part of the rear foot guide rail system. This is horse shoe shaped, with a larger amount of this higher durometer material on the medial side and decreasing as it wraps around the heel to the lateral aspect of the heel. These guide rails paired with the stiff heel counter and secure midfoot hold all add up to a very stable racer!

Durability

These shoes are holding up wonderfully.After running over 100 miles in them, I see
little to no wear.Also the midsole
material hasn’t lost any of its springiness and I contribute this to the blown
rubber on the outsole and the composition of BioMoGo and DNA.I see myself easily getting 400 miles out of
these shoes.

Room for Improvement

The laces, dear lord the laces!They are so long on these shoes.I really don’t understand why and I don’t
like the thinness/elasticity of them.I
feel that if Brooks took the laces from the Ravenna 9 and placed them on this
shoe it would make for easier lacing. The only thing I want Brooks to try out
is adding a thin layer and/or incorporating their new DNA AMP midsole material
into this shoe. I am curious about the DNA AMP, because on cold weather runs here in Up State New York, the cold weather tends to really firm up the midsole material (a downside of EVA based foams). By no means a deal breaker though.

Conclusion

If you are in the market for a racing shoe and need
stability, look no further!The Asteria
is a superb shoe that will not only compliment your biomechanics, but will keep
your feet protected and moving fast on race day from 1/2 marathons and up.Also, the high durability and acceptable price
of around 100 bucks makes me wonder why one would reach for anything else.It is very hard to find stability shoes that
are light weight and even rarer to find stability racers.I highly recommend you try them out!

Thanks for reading!

Editor's Note: As always, the views presented on this website belong to Dr. Klein, Dr. Kollias or the selected few who contribute to these posts. This website should not and does not serve as a replacement for seeking medical care. If you are currently injured or concerned about an injury, please see your local running physical therapist. If you are in the Los Angeles area, Dr. Klein is currently taking clients for running evaluations.

***Disclaimer: These shoes were a personal purchase from Brooks Running. We put at least 50-75 miles on trainers and 25 miles on racing flats prior to reviewing them. Currently Dr. Kollias has 130 miles on his pair in a variety of conditions. If you are a footwear rep looking for footwear reviews or consultations on development, we are currently looking to partner with companies to assist, discuss and promote footwear models. Partnership will not affect the honesty of our reviews.

Wednesday, February 28, 2018

We are now deep into the winter
season and much of the United States is experiencing some very cold weather
(especially up here in the Northeast!).If you are residing in California like Matt, well then I suppose
you can ignore this post (unless of course you run in the mountains).Likewise, I’m sure man of your furry friends
love partaking in runs on the road and the trails in this cold weather. As a veterinarian, I'd like to share with you some information regarding hypothermia, which is a medical condition that can affect dogs, and is something that requires some understanding to prevent. This is the first of many posts
that will shed some light on various dog related questions you might have.I hope that these posts will serve to provide basic information regarding common running-related canine health issues and will help everyone have happier, healthier dogs.Please note that my posts are not intended to replace your veterinarian's recommendations, and I highly recommend you always consult your personal veterinarian with any pressing medical questions.Onward with this first post on dog health!

My Border Collie Sugar and I enjoying a romp in a typical upstate New York winter storm.

What is Hypothermia?

Hypothermia is a medical condition
that involves the body having an abnormally low body temperature, which if left untreated, can lead
to disruption of various body systems and even death.This disruption is all related to how a
decreasing core temperature leads to a depression of the central nervous system
(CNS).This effect on the CNS is
important, because the CNS is responsible for controlling the body’s
homeostasis or “set-point” – in other words, the CNS acts as the thermostat for
your dog’s body.This “set-point” is
kept in a very narrow range, and if it increases (as with a fever from the flu)
or decreases (as with hypothermia), it deranges other body systems such as the
cardiovascular (heart and blood vessels), respiratory (lungs), and endocrine
(glucose metabolism, growth, digestion) systems.This medical condition is also considered a
form of shock, because it can result in life threatening alterations of blood
flow to vital organs.Finally, when a
dog is diagnosed with hypothermia, it is generally classified by the degree of
body temperature change as well as the clinical presentation (blood pressure,
neurological state, etc.).

The early clinical signs of hypothermia in your dog will
involve sluggishness, pale gums/tongue, and in-coordination.You may also appreciated a slowed heart rate
if you place your hand on the right ventral aspect of your dog’s chest.If allowed to progress, your dog can become
shocky, unresponsive, and/or experience frost bite of their peripheral tissues
(ears, toes, tip of tail).If you
appreciated any of these abnormal signs, it is imperative that you seek medical
attention as soon as possible from your local veterinarian or local emergency veterinary clinic.

What is Frostbite?

Frostbite is an ischemic condition, which is where the blood
flow to tissues is severely decreased or stopped.This disruption of adequate blood flow
causes a loss of oxygen to those tissues and possibly necrosis (dying
cells/tissues) of the affected region.This pathological process begins with a condition known as frostnip and
if left untreated, can progress to the classic frostbite people are most
familiar with (see figure 1).

One can
appreciate this on your dog as reddening of exposed skin (ears, muzzle, and
belly) and is a reversible process.Some
of you have likely experienced this, where your skin turns red on your fingers
and once you warm up you feel a tingling sensation.Past this early stage, your dog’s skin can be
damaged down to all the layers of the skin.The end result is blackened tissue that is dead and will likely slough
or fall off later on.If you appreciated
any of these abnormal signs, bring your dog indoors and seek medical attention
as soon as possible from your local veterinarian or local emergency veterinary clinic.

How to Prevent Cold
Weather Related Health Issues

The best medicine is to prevent
this medical condition from arising in the first place.The way to accomplish this is to either avoid
running with your dog in non-ideal conditions and/or having appropriate
protective equipment. But you may have the question, “how do you know if the
weather is non-deal for my dog(s)?”Simple, stand outside with what you are going to wear running and if it
feels too cold for you, it is likely too cold for your dog.The caveat to this is if you have running
gear for your dogs.Yes you heard me
right, running gear for your dog.This includes jackets, booties, and even doggie goggles to protect their eyes from
strong freezing winds.Another benefit of dog booties is that they protect dogs’ paws from salt that can be rather
corrosive and irritating to the exposed skin on their feet.

Another important aspect to
consider is the breed of dog you have.
Breeds such as huskies, Labradors, retrievers, collies, pointers, and Shepherds
are very cold resistant.This
adaptability comes from their thick double coats acting as a barrier from the
elements (also a reason to not shave these breeds in the summer, but that will
be discussed in a future post).If you
have a toy breed, chondrodysplastic breed (think stocky legged dogs –
dachshund, basset, beagle) or a brachiocephalic breed (think squished-face
breeds - pug, bulldog, boxer) they generally have a thinner coat and have a
decreased ability to thermoregulate due to their odd anatomy. These physical
attributes also make them less than ideal athletes and leave them open to other
types of injury.Granted, all dog breeds
need exercise, I just wouldn’t recommend an American bulldog as your running
partner.

My final point to consider is
medical history. If your dog has a
preexisting condition, such as a heart condition or is elderly, it is very
important to take extra precautions.In
other words, only do short easy runs with these dogs and avoid extreme cold or
hot.Most importantly with this point,
please consult your veterinarians for the appropriate amount and type of
exercise if your dog(s) have a chronic or potentially debilitating health
condition.

Final Thoughts

Running with your dog(s) in the cold
is a great way to maintain your furry friends’ sanity in the winter and is a
great form of exercise.Hopefully with a
little bit more understanding of these health issues and how to prevent them, you will be able to achieve more healthy and happy running with your dog(s).Thank you for reading and as always, tack on!
Thanks for reading!

Editor's Note: As always, the views presented on this website belong to myself or the selected few who contribute to these posts. This website should not and does not serve as a replacement for seeking medical care for you or your dog. If you have a health concern about your dog or suspect an injury, please see your personal or local veterinarian as soon as possible.

Saturday, February 24, 2018

If you have read my reviews before, you know I have a special place in my heart for light stability shoes. These are the types of shoes I tend to work best with because I usually need just a little bit of guidance. I can easily run in neutral shoes but perform best in these. So I was very excited when I saw the Sensation 3 (first on the feet of my girlfriend Regina Lopez, who is currently sponsored by them). Upon inspection, it was immediately apparent that these were not moderate or high support shoes. These were mild stability shoes meant to guide the foot, support you during mileage and help you pick up the pace. Did I have the same experience? Let's talk.

The first thing I noticed about this shoe was the stability and firmness of the ride. The QU!KFOAM tends to come most to life when the pace picks up. One of the runs I used these for was a light fartlek and I was surprised how the shoe transforms from a firm ride to a bouncy fast ride as you put more force into it. The ride is very consistent from heel to toe, which is partially due to the full length QU!KFOAM. It also remains consistent over the course of the run. Many shoes tend to bottom out as you pound away at them. The QU!KFOAM maintains its consistency from the first mile to the last.

361 shoes tend to be very durable and this one is no exception. While I have not put enough miles on them to truly test this, every 361 shoe has lasted me well over 500 miles (which is rare given how hard I am on shoes) and have maintained similar rides throughout. The outsole rubber definitely contributes to the firmness of the ride, but the durability trade off and responsiveness of the sole is definitely worth it.

As a stability shoe, there is a mild medial post (gray discolored material) in the midfoot. The post is very non-intrusive and even neutral runners will be able to run comfortably in this shoe. There is also a carbon fiber plate in the midfoot that definitely contributes to the ability to take this shoe into uptempo paces (despite being a trainer). Both add to the sense of stability in the shoe along with the firmer ride and full ground contact outsole.

Upper/Fit

The first thing I notice about the Sensation 3 is that the fit is on the narrower side. The mesh upper is definitely stretchy and conforms very well to the foot. The last (shape) and fit of the shoe just runs narrower. The fit is very much true to size (I generally wear size 10 and this is exactly how the shoe fits) and the heel is somewhat snug, holding the rearfoot very well.

There is a solid external heel counter in the shoe, which means that although there is a stable rearfoot, there is still soft lining touching your achilles and calcaneus/heel bone. So most people that are sensitive back there should be fine.

I am impressed with how stretchy the mesh in the forefoot is. I am really tired of companies using aggressive toe bumpers on road shoes. These tend to cause more problems as I continue to observe tearing there and a TON of blisters from patients. This is NOT the case with the Sensation 3 as the entire front is mesh with just a little bit of a light flexible guard at the front for durability. So for those with normal to narrow feet, this should be a shoe that provides enough stretch around the toes.

Thoughts as a DPT

A mild medial post, a firmer midsole, a full ground contact outsole, an external heel counter and a carbon fiber plate in the midsole makes this shoe a very stable shoe but not in the traditional sense. The running shoe industry still views "support" as how much medial posting there is. This is quickly chancing just as the definition of "support" is ever evolving, but 361 has done a great job of stabilizing the foot using a combination of milder methods.

I realize I said 4 things below but mentioned 5 above. The full ground contact outsole goes without saying. More ground contact means more stability.

The medial post obviously functions to slow down the rate of pronation. In the Sensation 3, the post is fairly mild, to the point I actually felt the plate far more than the post. The carbon fiber plate adds additional rigidity into the midfoot (which needs to be stable to assist during the propulsive phase of gait). The firmness of the midsole and QU!KFOAM also make the shoe more stable (think concrete vs a soft mattress). The external heel counter holds the rearfoot (to a degree) to stabilize the calcaneus. All four of these together add up to a stable shoe, but none are overbearing. This is a great way to do this, as many people are VERY sensitive to medial posts. I see this frequently in people who refuse to wear their $600 custom orthotics. They may be custom made, but they won't work if the person doesn't have highly sensitive feet because they won't wear them!

Conclusion

For those with narrower feet looking for a firm, stable and versatile daily trainer, I would take a look at the Sensation 3. The support elements are mild enough that even a neutral runner could easily use this shoe for some extra stability on long runs. Meanwhile, the carbon fiber plate and QU!KFOAM really come to light when the pace picks up. This is a shoe I would reach for during long runs and longer workouts. Even for those looking for a little more shoe than traditional marathon racers, this would make a great shoe for long distance racing.

Due to the narrower width, I will be sending these to my co-writer here on Doctors of Running, Dr. Kollias as he has narrow feet and needs more rearfoot stability that I do. Look for a full review here in the coming weeks!

Thanks for reading!

Editor's Note: As always, the views presented on this website belong to myself or the selected few who contribute to these posts. This website should not and does not serve as a replacement for seeking medical care. If you are currently injured or concerned about an injury, please see your local running physical therapist. If you are in the Los Angeles area, I am currently taking clients for running evaluations.

***Disclaimer: These shoes were provided free of charge in exchange for a review by 361 USA. We very much appreciate them sending these to us and thank them for their support. This did not change the honesty of these reviews. We put at least 50-75 miles on trainers and 25 miles on racing flats prior to reviewing them. Currently I have 10 miles on my pair and will be sending them to Dr. Kollias for a full review (coming soon). My views are based on my extensive history in the footwear industry and years testing and developing footwear. If you are a footwear rep looking for footwear reviews or consultations on development, we are currently looking to partner with companies to assist, discuss and promote footwear models. Partnership will not affect the honesty of our reviews.

Sunday, February 18, 2018

This review comes from a combination of Chris Park, a fellow shoe geek and contributor to Doctors of Running and myself, Dr. Matthew Klein, PT DPT. I had the pleasure of receiving this shoe early from Skechers Performance while Chris came upon it later. We both have unique thoughts on the shoe and are excited to share them. Chris - Don't judge a shoe by its brand. While hundreds of people have preconceived notions about the Skechers brand, I ask that you keep an open mind with these reviews, for you might be surprised. The Skechers GOrun Ride 7s are my favorite and current daily trainer. Since its release, I have logged hundreds of miles of slow long runs and fast track workouts. Recently, Skechers released another of their new line, the GOrun 6. Toted as a ligthweight, cushioned neutral running shoe, the GR6 are designed for speed and comfort in an "all in one package".Dr. Klein - I loved the GOrun 5 as a performance shoe that I used for many fartlek and interval sessions. It was the kind of shoe that asked for speed. The problem was that it was very similar in function to the Razor, which was confusing. I was very surprised to see the update with version 6. This shoe reminds me what I wanted during my minimal running days. A lightweight flexible upper and a low drop sole is something that I would have loved at that time. Now my tastes are a bit different, but I appreciate what Skechers has done with this shoe. It has several different personalities, so let's talk about them.

Specs:

Weight: 7.2 oz (size 9)

Drop: 4mm (20mm/16mm)

Classification: Lightweight Trainer

Chris - According to Skechers, the GR6 is the "latest generation in the Skechers GOrun series of lightweight, cushioned neutral running shoes." Like the Vazee Pace 2s I reviewed previously (REVIEW), the GR6 is marketed as the "jack of all trades" because of its lightweight, responsive construction while still having enough cushion to be a daily trainer.

Ride/Sole/Drop:

Chris - As previously mentioned, the GR6 is marketed as a lightweight, daily trainer with the needed cushioning to run a marathon but enough responsiveness for 200m repeats. This is largely due to Skechers new FLIGHT GEN midsole which delivers a great responsive, snappy ride. Skechers has been implementing FLIGHT GEN in many of their recent shoes, and I can definitely say that I’m a huge fan of it. Despite the incorporation of FLIGHT GEN in numerous models, each model provides a completely different feel. Whereas the Ride 7s provide a softer, plusher ride, I would say that the GR6 offers a firmer, lower to the ground midsole.

It reminded me of a more responsive, comfortable, and lower to the ground Zante.

As I mentioned in my review of the New Balance Vazee Pace v2s, it was hard to fit those

shoes into a particular niche. While they were great shoes, the Pace v2s felt more like a lightweight trainer than a racer. Unfortunately, this made the entire line quite confusing because there were other models – from New Balance themselves – that offered more versatility. The GR6, however, I believe is the perfect blend between the Ride 7, which is a cushioned, “long run” trainer and Razor 2, the perfect racing flat for a marathon.

It has the needed responsiveness and better ground feel in a lighter package to distinguish it from the Ride 7s, but also the needed cushioning and comfort in a slightly heavier package to separate it from the Razor 2s.

Although I prefer a 6mm drop in most shoes, I was still a fan of the 4mm drop. The offset helped the shoes feel more like a racer and distinguish it from the GoRun Ride 7s. A lower drop encourages greater toe off and midfoot strike, hence why lighter racing flats feature little to no drop.

Dr. Klein - Having tested the entire range of the new Skechers line, I have begun to appreciate the many forms of FLIGHT GEN. The GOrun 6 is definitely a more minimal and slightly firmer demonstration of this midsole. The shoe runs somewhat close to the ground, which makes sense that it would be a bit firmer. It is not bone crushing firm and the FLIGHT GEN adds some bounce for sure, but it is firmer than the GOrun 5. The nice thing about Skechers is that their soles are very consistent. The same material and design is utilized throughout the midsole, so expect to have similar riding features no matter where you land.
Like the previous version, gone is the M strike. The sole has a smoother ride and has fullground contact. This contributes to better grip and a slightly more stable sole. The chevron pattern on the outsole does add some mild grip to the road as well as awesome flexibility throughout. This shoe is definitely the moderate minimalist's dream. The sole appears to be slightly wider than the previous version. This makes the shoea little more stable and would have set it up to be a great uptempo shoe (which again wouldhave made the difference between the Razor and GOrun confusing), however the flexibilityof the upper defeats this a bit (read on below).

Fit/Feel:

Chris - The GR6 features a compression knit upper and molded heel counter.

While I am a huge fan of the sole/ride, the GR6 is not without faults. Don’t get me wrong, initially I was a huge fan of the Compression Knit Upper. Right out of the box, it felt extremely soft and almost supple to the touch. Unfortunately, this was the source of my problems. Most uppers feature some sort of mechanism for lock down and support. With the GR6s, however, I found that the upper had no sort of heel, midfoot, or forefoot lockdown. Despite tying the laces as tight as I could, my foot was not stable (I believe this is partly due to the upper and lace hole construction).

The Compression Knit Upper reminded me of the Adidas Energy Boost 3. It was extremely

stretchy. Almost too stretchy. While comfortable, I found that the stretch compromised some mid/forefoot support. Again. This is all subjective. There were many people who were absolutely thrilled with this breathable, knit upper. I, however, did not find it to pair well with the responsive, snappy midsole. I found that my heel slipped out with the slightest tug on the back. *I have fairly narrow feet and prefer a tight fit around my foot when running. If you prefer or do not mind a looser fit, the fit may not bother you.

Despite the presence of a molded heel counter, I did not notice much of a difference in comparison to similar knitted shoes (Nike Flyknit) with a knit heel counter. I want to emphasize that these shoes were not uncomfortable by any means. I just found

them to be a little too loose around the heel and midfoot for a tempo/faster shoe. As I mentioned, during some faster tempos, I was worried that my heels would slip out of the shoe. **I am a huge fan of the upper on the Ride 7. While it is also knit, I found the upper to provide far better lock down and heel support.

Dr. Klein - While the upper is incredibly comfortable and fits like a sock against the skin, it is too flexible for faster running. I actually like the GOrun 6 better as a casual shoe than as a running shoe to be honest for this reason. I used the GOrun 6 as a minimal trainer for foot strengthening, but did not do much faster running other than one workouts and many strides. There is not enough hold on the foot to handle changes in speed or quick turns. Turning in this shoe would have my foot sliding off the platform. There are no additional mechanisms for lockdown in the upper. It is stretchy throughout even with a very mild heel counter, which is mostly just increased density of the knit upper.

I do understand what Skechers Performance was trying to do with the upper. The "Compression Knit Upper" is designed to fit closely to the skin and try to hold the foot. While this works great with low speed activities, it does not suffice for high speed or turning movements. That being said, the upper is incredibly comfortable against bare skin and I have been able to wear these sockless both for short easy runs as well as casually (they have some cool colorways out there). There are points of increased density in the upper in an attemptto hold the foot in certain places, but I do not feel like it is enough to provide a really secure fit. This shoe does fit very trued to size and I would stick with your normal size. The GOrun 6 runs a bit snug due to the stretchy upper If you find them a bit too snug, you can easily take out the sockliner and that should give you more room. I actuallyprefer running without the sockliner as I get a little better proprioceptive feedback (since I mostly use this shoe as a short run shoe for foot strengthening).

Notice the laces integrated into the upper. This does a great job of snugging the upper

down but does not add additional lock down or security for the foot.

Thoughts as a DPTDr. Klein - Again I appreciate the more anatomic shape of the upper and the flexibility fortoe splay. However, balance is key here. The upper of a shoe needs to help secure the foot to the platform (sole) while not being too restrictive. The amount of flexibility in the correctareas is key to helping the foot move the way it is supposed to without having it fly out ofthe shoe. In the case of the GOrun 6, the entire upper is flexible. Some people will love this.
Personally, I have found this makes faster running very difficult as there is little to no
foot lock down or security. A key area the foot needs to be able to move at are the
toes, especially medial and laterally for toe splay. Most of the rest of the foot, particularly
the midfoot, can be locked down decently. Of course if one has sensitive calcani (where the
achilles inserts) then flexibility is great back there too. However, having a locked in heel is
great to prevent heel slippage, something I felt was going to happen every time I tried to pick
up the pace in the GOrun 6 (although it never actually happened to be fair).

Skechers did attempt to change the densities of the upper to match where they wanted flexibility. However I do not think it was enough to provide a secure fit. Somehow though you have to keep that foot locked down. I highly suggest Skechers simply further increase the density of weave in the midfoot and heel to hold the foot down better. Decreased security of the upper may lead to other methods of the body trying to keep the shoe on, with toe clenching (flexion) being the most common one I see. This is very common in people who wear flip flops a great deal. The toes curl and you over utilize the long flexors of the foot to try to keep those on. Then people wonder why their feet hurt after walking all day doing that. Regardless, improved foot lock down in this shoe could help decrease some of those compensations (although people toe clench for many other reasons, but that is a post for another day).

Weight/Durability:

Chris - On Runningwarehouse.com, the GR6 is listed at 7.2 ounces in a size 9 US. This is the perfect weight range for a shoe in this category. Not too light, but also not too heavy. It helps distinguish the shoe from other models and fits into a larger niche: lightweight, daily trainer. The outsole features Skechers’ Parametric Web Outsole which provides great traction on trails,

tartan, and asphalt. These are definitely durable shoes. While I’m not too sure how the upper will hold up, if the GR6 midsole is anything like the Ride 7s, I expect the FLIGHT FOAM to last well over 300 miles.

Dr. Klein - The GOrun 6 is light. As Chris mentioned, it is listed at 7.2 oz. Definitely one of those very lightweight/minimal trainers. I'm sure some people could get away with racing in this shoe as it is light enough. I personally would want something far more secure for racing.
Durability is fairly average, especially for a ligthtweight trainer. I would not expect more than 250-300 miles out of these but my pair have handled both running and casual wear quite well. The midsole does last due to the FLIGHT FOAM but the outsole is wearing at a fairly average rate.

Conclusion and Room for Improvement:

Chris - This shoe has a ton of potential. Although I’m not the biggest fan of the upper lockdown, I love the responsive FLIGHT FOAM midsole. In future models, I’d like to see a change in the upper design. I think I understand where Skechers was going, but I didn’t really work for me. The soft upper made it felt more like a casual, walking shoe more than a performance running shoe. I would recommend these for anything up to the marathon distance and for anyone looking for a lightweight, versatile trainer. They will definitely handle any workout or long run without beating up your legs. I appreciate what Skechers did with their incorporation of the GR6 in their full lineup. It is now a very different and unique shoe from the Razor 2.

Dr. Klein - I love this shoe as a casual shoe. The upper is so comfortable against bare skin and actually looks decent. As a running shoe, the upper is not secure enough for uptempo work (the Razor 2 definitely shines there) and there is not enough sole for me to use as a daily trainer. Thus the GOrun 6 fits perfectly as a very lightweight or minimal running shoe. Those that like minimal running shoes (and are still holding on to barefoot running extremes) will love this shoe as a balance between cushioning and minimal feel. This shoe is now VERY different from the Razor, so there should not be major confusion between the two anymore. I do hope that Skechers does lock down the foot a little better in the GOrun 7. The GOrun Ride 7 has a great example of this where the mesh is stretchy but there are aspects of the upper that still hold the foot well. So it can be done.

Editor's Note: As always, the views presented on this website belong to myself or the selected few who contribute to these posts. This website should not and does not serve as a replacement for seeking medical care. If you are currently injured or concerned about an injury, please see your local running physical therapist. If you are in the Los Angeles area, I am currently taking clients for running evaluations.

Currently Chris has 25 miles on his pair of GOrun 6s and I have 143 on mine. We put at least 50-75 miles on trainers and 25 miles on racing flats prior to reviewing them. If you are a footwear rep looking for footwear reviews or consultations on development, we are currently looking to partner with companies to assist, discuss and promote footwear models. Partnership will not affect the honesty of our reviews.

***Disclaimer: These shoes were purchased by Chris Park for their full US retail price. Skechers Performance provided my pair to me free of charge in exchange for a review. This did not change the honesty of these reviews.